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It’s Time to Review Your Health Insurance Policy

Four scenarios to re-evaluate your current health plan

Written by: Andrew Hall.

Key Takeaways

  • You should review your policy at least once a year to ensure you’re getting the most from your benefits, especially if your health needs change.

  • Make sure to understand the costs associated with your plan, like your premiumA premium is a fee you pay to your insurance company for a health plan coverage. This is usually a monthly cost. and deductibleA deductible is the amount you pay out of pocket before your insurance company covers its portion of your medical bills. For example: If your deductible is $1,000, your insurance company will not cover any costs until you pay the first $1,000 yourself. — and how they affect your coverage.

Young woman reviews her health insurance policy online.

Change Isn’t Always Bad.

When it comes to health insurance, a regular re-evaluation of your plan is essential to making sure you aren’t paying for unnecessary coverage or experiencing gaps in coverage that could leave you financially exposed.

Below are four scenarios that should trigger a health plan re-evaluation.

Your premiums keep increasing.

If your premiums keep increasing, switching to a new plan may limit the increase in monthly costs. When purchasing coverage on a health insurance marketplace, you are put into a “pool” with other individuals purchasing coverage. As that pool gets older and sometimes more sickly, the health insurance premiums can increase for the entire pool — even if you haven’t incurred a large amount of claims personally.

Searching for similar plans at a lower price point can help you save on monthly premiums without narrowing your coverage.

You haven’t gone to the doctor for a long time.

Many people may think that since they haven’t gone to the doctor in a long time they can cancel their policy. Because most Americans are required to carry health insurance under the Affordable Care Act (ACA) to avoid a penalty, canceling your coverage isn’t your best option. Instead, try switching to a more economical plan.

Switching to a plan with a higher deductible and lower monthly premiums can be a good option if you are generally healthy and are not a heavy utilizer of your health plan. In addition to saving you money month-to-month, high deductible plans allow you to open a Health Savings Account (HSA). An HSA gives you the ability to save funds for future illnesses or injuries instead of spending them on premiums for a plan that you aren’t using now.

Your family structure has changed (or will soon).

Whether you are getting married, divorced, or considering expanding your family, making sure your health plan considers these changes is critical. Because health care needs vary from person to person, it’s important to make sure your health plan scales up or down following your family changes.

Additionally, if you already have children and they are going away to college, make sure that there are covered health care providers in their geographic area to ensure they are able to receive covered care.

Your prescription drug needs have changed.

People who take monthly maintenance medications often need higher prescription drug coverage levels than those who don’t. If you or someone in your family requires ongoing prescriptions as a part of a treatment plan, consider switching to a plan with lower monthly copays for prescriptions.

Similarly, if you or someone in your family comes off a maintenance medication, switching to a plan with less robust prescription drug coverage could save you money month-to-month.


What is a Qualifying Life Event (QLE)?

A change like getting married, having a baby, or losing coverage can make you eligible for a Special Enrollment Period.

How long does it take for insurance to switch?

Once you’ve enrolled and made your first payment it can take a few weeks. If you applied for major medical health insurance, your coverage will typically begin on the first day of the following month.

What's Next?